Deport 20 million plus illegal immigrants .
If you drive along Southern Arizona's border with Mexico long enough, you might see a lone illegal wandering the desert. Or maybe he's hunched at the roadside sipping water from his milk jug. What's he doing there, and where are his compatriots, the people he broke into the country with?
The uninformed might ask those questions, but those who live with the daily invasion across our open borders can make a pretty good guess what's happening. The fellow got bounced from his group by the coyote-guide. Two transgressions will get an illegal cut loose with certainty: Either he can't pay, or he shows signs of tuberculosis.
You think these coyotes are fools? They don't want some hollow-eyed lunger hacking and coughing blood on them. So it's adios, pal, and now you're America's problem. But they know that already. Every illegal realizes that if he makes it to an emergency room in Southern Arizona, or anywhere around the country for that matter, he can get treatment, free of charge.
It's federal law, and has been for 20 years. In its evolution, the policy has become a kind of federal health insurance program for illegals, and its rising costs are eating up resources that could otherwise go to poor and uninsured American citizens. It has created a financial nightmare for border hospitals and contributed to cutbacks in services at Tucson hospitals.
Is this an outrage? A scandal? Some think it's both. But going back to our active TB sufferer, here's something even worse: The guy can't get treatment anywhere, goes underground and takes a job at a restaurant in Tucson or L.A., and coughs his way to infecting scores of others.
Talk about a Hobson's choice. But as with everything in the ongoing crisis of illegal immigration, the hard choices would largely evaporate if the federal government fulfilled its constitutional duty and took control of our border.
The threat illegal immigration poses to American public health plays out every day at Arizona's hospitals. Until recently, the issue remained only marginally public, a problem medical people batted around among themselves, not with the media. Even today, several hospitals contacted for this story declined comment.
The Copper Queen Hospital in Bisbee, one of the hardest hit, helped break that barrier when CEO Jim Dickson began returning reporters' calls, even though the subject, as he puts it, has become "like the third rail. You don't want to touch it."
But his problem had grown severe. Dickson's uncompensated costs for treating illegals rose from $35,000 in 1999 to $450,000 in 2004. His total shortfall now sits at about $1.4 million, a hefty deficit for a 14-bed hospital. To make ends meet, he had to close, in June 2000, the Copper Queen's long-term care facility, and cut back on staff and hours, forcing some employees to take second jobs to survive.
The hospital has seen a ray of light, however. In the first months of 2005, the Copper Queen has gone back into surplus, in part because more illegals are in Border Patrol custody when brought in to the hospital. That means the Border Patrol must reimburse the Queen for the cost. In the past, agents would drop injured illegals not in their custody at the ER and take off, sticking the hospital with bills that never got paid.
Another reason for the decrease, says Dickson: the Minuteman Project.
"It's been terrific for us in April," he says, cutting down on the number of people coming across and therefore the number requiring ER treatment. Dickson says the hospital wrote off about $6,000 in losses in April this year, compared to about $35,000 in April 2004.
The central issue, though, remains in place--the hospital has had to scale back health services to American citizens to treat illegals. Bisbee isn't alone.
The most comprehensive study on the subject found that 24 counties in four states bordering Mexico wracked up $190 million in unpaid emergency medical bills caring for illegals in the year 2000. The study, commissioned by the U.S.-Mexico Border Counties Coalition, found that California spent $79 million of that; Texas, $74 million; Arizona, $31 million; and New Mexico, $6 million.
Bear in mind that these numbers, the best available, are from 2000. We can assume, with increasing rates of crossings since then, the costs are considerably higher today. Nor do the above figures take into account non-border counties. Treating illegals in Maricopa County costs as much as $50 million a year, according to an estimate used by Republican Sen. Jon Kyl. Nationally, American hospitals lose $1.45 billion a year.
The Medicare reform bill passed in 2003 allocated $1 billion to reimburse states for federally mandated ER care given to illegals--about $45 million a year of that to come to Arizona over four years. But even that, some hospital staffers say, is little more than a Band-Aid on a huge problem.
Ruth Kish, director of patient care services at Copper Queen, expects that under the repayment formula, her hospital will receive only 10 cents of every dollar they spend on illegals. "But every bit helps," says Kish.
Another factor: The counties in the above-mentioned study spent an additional $13 million in 2000 on emergency transportation, such as helicopters and ambulances, to pick up illegals injured after sneaking across the line.
The Bisbee Fire Department's ambulance responds to about one of these calls a day during the summer, says Chief Jack Earnest. Asked how many of these patients pay up, Earnest wasn't sure, and recommended contacting the billing office in Sierra Vista. The billing office knew exactly how often illegals pay their ambulance bills--never.
But there's another category--Mexicans injured in Mexico who call American ambulances for help. By federal law, they have to respond, which makes Bisbee's Copper Queen the trauma center of choice for Sonora's northern frontier.
The calls come from Naco, Sonora, the town across the line just south of Bisbee, where, in spite of widespread poverty, cell phones are popular, and everybody knows the Americans are bound by law to treat them.
"When we get a call we go, and we don't ask where the person's from," says Earnest. Naco residents needing care go to the port of entry and declare an emergency to American officials. When they're waved through, they're transported to the Copper Queen's ER in Bisbee's ambulance, or they drive themselves in private cars.
The policy is called Compassionate Entry, and it applies to hospitals up and down the line. The Copper Queen averages about five such cases a month. Some abuse the privilege, says ER Manager Josie Mincher.
She's seen Compassionate Entries with bad sore throats and others who aren't sick at all. One pregnant girl landed in the ER recently complaining of morning sickness.
Most are seriously sick, though, and the staff rushes to help, "because that's what we do," says Mincher. But it doesn't take much to blow the budget. "Just walking in the door is $400," says Mincher. "It's not unusual to have one UDA (undocumented alien) cost $5,000, and we know we're not going to get that back. We're playing with monopoly money here."
Here's an example of how one patient can wrack up a huge bill:
A young Mexican man had a bad auto accident across the line and was taken to Douglas' Southeast Arizona Medical Center with severe neurological problems. After being stabilized there, he was transferred to Barrow's Neurological Center in Phoenix.
He spent a costly month there, courtesy of the Center, and was transferred--with a tracheotomy tube in his throat and supplies to clean it, also provided gratis by Barrow's--to a hospital in Hermosillo. That facility kept him less than a day before releasing him to his home in Naco. But for reasons no one can explain, the Hermosillo hospital kept his trach kit and cleaning supplies.
As a result, he became septic--a bad infection--and came through the Naco port under Compassionate Entry to the Copper Queen. He spent three days there, then the staff sent him off, with more free supplies, to a clinic in Agua Prieta for continued care.
How much did this fellow cost the American health care system? A figure of a quarter-million dollars would surprise no one. Cost to the Copper Queen? Almost $6,000, and they got none of it back.
Northern Cochise Community Hospital is in Willcox, far enough from the border that it doesn't get patients crossing the line for health care. But that doesn't mean it escapes the invasion.
CEO Chris Cronberg loses about $100,000 a year caring for illegals, mostly those injured in traffic accidents when their loaded vehicle flips while speeding north. "It's not make or break for us," says Cronberg. "But as a small hospital, we depend on cash, and those are dollars that aren't coming in, so it has an impact."
The same is true at Sierra Vista Regional Health Center, according to Vice President Marie Wurth. She expects the hospital to lose $250,000 this year treating those who jump the line, get hurt doing it and don't pay their bills.
The big squeeze is on in Tucson, too. Tucson Medical Center loses an estimated $4 million every year treating illegals.
The corresponding figure at UMC, which includes some foreign nationals, was $3.5 million for fiscal 2004, a $2 million increase from the previous year. Part of that is attributable to UMC, in July 2003, becoming Tucson's only Level One trauma center, meaning it saw the most serious cases.